Summary & Overview
CPT 63283: Sacral Laminectomy with Intradural Lesion Excision
Headline: CPT code 63283: Sacral laminectomy with intradural lesion excision — surgical removal and tissue sampling
Lead: CPT code 63283 captures a neurosurgical procedure in which part of the sacral lamina is removed and an intradural spinal cord lesion is excised with tissue sent for pathology. This code is used to document complex spine surgery involving the dura and neural elements and has implications for surgical coding, hospital billing, and coverage determinations.
Why it matters nationally: Intradural spinal tumor resections are high-acuity procedures with significant resource use, perioperative care needs, and potential for complications. Accurate coding with CPT code 63283 is important for clinical tracking, hospital reimbursement, quality measurement, and utilization management across national payers.
Key payers covered: Analysis typically covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides benchmarks and coding context for CPT code 63283, summarizes common clinical indications and sites of service, outlines typical documentation elements tied to the procedure description, and highlights policy and coverage topics relevant to inpatient and OR-based neurosurgical services. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 63283 describes a surgical procedure in which a portion of the sacral vertebra known as the lamina is removed (laminotomy/laminectomy) and an intradural spinal cord lesion is excised with a sample of the lesion sent for pathological testing. Service type: Neurosurgical intradural tumor resection with partial sacral laminectomy. Typical site of service: Hospital operating room or inpatient surgical unit, often performed by a neurosurgeon or spine surgeon.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents with progressive lower back pain, radicular sacral symptoms, and new-onset bowel or bladder dysfunction. MRI of the lumbosacral spine identifies an intradural extramedullary lesion at the sacral level consistent with a meningioma or nerve sheath tumor compressing the cauda equina. After neurosurgical consultation, the patient is scheduled for surgical decompression with laminectomy and intradural tumor resection. The operative workflow includes preoperative localization imaging and anesthesia evaluation, positioning in the prone position, a targeted sacral laminectomy to expose the dura, durotomy and microsurgical excision of the intradural lesion, hemostasis, sending a specimen of the lesion to pathology for permanent section, watertight dural closure, and layered wound closure. Typical perioperative care includes intraoperative neurophysiologic monitoring as indicated, postoperative neurological assessments, pain control, and rehabilitation planning. The typical site of service is an inpatient hospital operating room or an ambulatory surgery center when clinically appropriate, under general anesthesia. The service type is a major surgical neurosurgical procedure involving spine decompression and intradural tumor excision.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons of different specialties work together as primary surgeons during complex intradural resection. |